What can you do to improve your fertility

So you and your partner have made an important decision to start a family. Like most couples, you may take fertility and pregnancy for granted. While for some couples getting pregnant is easy, for others it’s not. So if you are trying to conceive, consider these simple fertility boosting strategies to improve your chances.

Time is of the essence

In making a decision about when to start a family, you should keep in mind basic fertility facts:

Fertility in women peaks at about age 25, then significantly decreases beginning at age 32 and drops off rapidly after age 37, reflecting, primarily, a decrease in egg quality.
At age 30, you have about 20% chance of conceiving per month, decreasing to only 5% per month when you reach the age of 40.
90% of the eggs are abnormal after age 40.

The take home message is that you can not put off pregnancy indefinitely, because getting pregnant may become more difficult as you get older.

Understanding the “fertile window”

Because sperm can survive for up to 5-7 days in the cervical mucus, the “fertile window” includes the day of ovulation and the four or five days before ovulation. The egg (oocyte), on the other hand, can survive for only 12-18 hours after ovulation occurs. If sperm is not available to fertilize the egg during this time, the egg will deteriorate and pregnancy will not occur.

Predicting your ovulation

Predicting the time of ovulation is not always easy even if you have regular cycles. Researchers evaluated several methods, such as, the menstrual calendar, changes in your daily basal temperature, ovulation predictor kits and cervical mucus monitoring to try to predict ovulation. Here are some simple measures you may want to consider if you are ready to conceive.

Know your cycle. A relatively simple method to try to estimate the day of ovulation is to subtract 14 days from your cycle length. So if, for example, your cycle length is 28 days (counting from the 1st day of your period), you probably ovulate on about day 14, give or take a day or two. If you have 32 day cycles, then you are more likely to ovulate on or about day 18 of cycle.
Make love frequently. The probability of achieving pregnancy is the highest when intercourse occurs every 1-2 days during the “fertile window” (beginning 5 days before ovulation). Surprisingly, sperm quality does not decrease with daily intercourse even in men who have low sperm counts, so you don’t have to worry about having sex too often. However, the pressure of having mandatory sex during the “fertile window” can add to the stress associated with infertility, so you may want to try making love every couple of days all month long.
The menstrual calendar is not always predictive of ovulation, so you may want to use an ovulation predictor kit to check your urine for the ovulation triggering hormone (LH). This, together with monitoring the changes in cervical mucus, has been found to help couples achieve pregnancy quicker especially if they are not engaged in frequent intercourse. However, keep in mind that false readings can occur in about 10% of the cycles.
When monitoring your cervical mucus, the probability of pregnancy is highest when the mucus is clear and slippery, having the consistency of an egg white. This change usually begins about 2 days before ovulation.

Watch Your Weight

Fertility rates are decreased in women who are either obese or very thin, because too much or too little estrogen production may shut down the ovulation process and lower the likelihood of a successful pregnancy.

So aim for a healthy weight. Exercise can help you maintain a healthy weight. If you are overweight, losing only 5-10 percent of your weight can improve your ovulation and improve your chances for pregnancy.

Nutrition and lifestyle

Consider switching to organic food to minimize exposure to pesticides.
Elevated blood mercury levels from seafood have been linked with infertility, so you may want to limit your fish intake to once or twice a week.
Avoid, or least limit, occupational hazards such as exposure to industrial solvents or toxins (dry cleaning, lead), pesticides, anesthetic gases and electric or microwave radiation.
Research shows that if you are trying to conceive, it is best to avoid high alcohol consumption (2 or more drinks/day) because the risk of infertility is increased by 60%. During pregnancy, alcohol should be avoided altogether because it is harmful to the developing fetus.
Make sure to include protein-rich foods in your diet, such as meat, nuts, dairy products, eggs, and beans.

Smoking has been shown to increase the risk of infertility by 60%. Men who smoke have decreased sperm count and movement. Nicotine in cigarettes constricts blood vessels to the ovary damaging a woman’s eggs and causing her ovaries to age prematurely. Smoking also has been found to increase the risk of miscarriage and ectopic pregnancy where the pregnancy implants outside of the uterus (most commonly in the fallopian tubes).

Drinking 5 or more cups of coffee/day (500 mg) have been associated with a 45% decrease in fertility rate. During pregnancy, caffeine consumption over 200 to 300 mg/day may increase your risk for miscarriage.
So limit caffeine, nicotine and alcohol intake. You may consider substituting green tea for coffee and soda.
Illicit drug use increases the risk of infertility by 70% and has been shown to be harmful to the fetus. Testosterone supplements and anabolic steroids given to men for body building in the local gym can severely decrease sperm counts.
You should take a folic acid supplement (400 mg/day) to reduce the risk of neural tube defects. Some nutritionists recommend antioxidants, high-quality multivitamin and minerals including iron, folic acid and B, C and E, vitamin B-12, L-arginine and L-carnitine, coenzyme Q-10, selenium, bee pollen and wheatgrass, but there is no conclusive evidence that such nutritional remedies improve your fertility.
Water–based vaginal lubricants, such as KY Jelly or Astro-glide have been shown to decrease the ability of the sperm to swim – a skill necessary to reach the egg. So if you must use lubrication during sex, opt for mineral or canola oil or commercial preparations such as Pre-Seed.
Douching should be avoided while trying to conceive or during pregnancy because it may wipe out the normal vaginal bacteria. This can put you at risk for bacterial vaginosis (BV) and increase your risk of infertility, miscarriages and premature labor.

Don’t ignore your male partner’s reproductive health

It takes almost three months for a man to make new sperm, so he needs to think ahead too.

Testosterone supplements and anabolic steroids decrease fertility and should be avoided.
Have him stay clear of cigarettes, alcohol or illicit drug use which can contribute to lower sperm production or motility.
There are several studies associating low intake of dietary antioxidants with lower sperm motility, so make sure he eats plenty of fruits and vegetables.
Several (controversial) studies link high intake of meat processed foods (sausages), soy foods and soy isoflavone with lower sperm concentration.
Reduce stress. Research shows that men undergoing stressful situations have lower sperm count and mobility. This is attributed to a higher level of the stress hormone cortisol which lowers the hormones responsible for sperm production. Stress can also lower a man’s testosterone level and reduce sexual function.

Stress reduction

The stress associated with infertility may result in less frequent intercourse and more difficulty conceiving.

There are several things that you can do to manage your stress:

Spend about one hour per day in some form of exercise such as walking or yoga.
Get adequate sleep.
You may also consider acupuncture which increase endorphins, the "feel good" brain chemicals. Acupuncture has been reported to improve success rates of In Vitro Fertilization (IVF), possibly by improving egg quality and decreasing the anxiety associated with fertility treatment.

Seek help early

If you do not have regular periods.
If you have history of pelvic infection or pelvic surgery.
If you are over 35 and you have not conceived after six months of unprotected intercourse.
If you are over 40 you should seek medical advice without further delay.

In summary, if you have difficulty conceiving, integrating conventional reproductive medical therapy with nutritional and lifestyle modifications, and acupuncture may improve your chances of a successful outcome. You should consult with your physician to discuss how best to optimize your fertility potential.